Review ArticlesCardiovascular Disorders Mediated by Autonomic Nervous System DysfunctionKhemani, Pravin MD*; Mehdirad, Ali A. MD, FACC†Author Information From the *Movement Disorders, Swedish Neuroscience Institute, Seattle, WA; †Medicine Service, Carl Vinson VA Medical Center, Dublin, GA. Disclosures: P. Khemani has served as a speaker for TEVA and St. Jude and as an advisory board attendee for Allergan and Lundbeck. A.A. Mehdirad has served as a speaker for Lundbeck, Pfizer, and Bristol-Myers Squibb. The authors received no direct compensation related to the development of the manuscript. This work was supported by Lundbeck. Correspondence: Ali A. Mehdirad, MD, FACC, Carl Vinson VA Medical Center, 1826 Veterans Blvd, Dublin, GA 31021. E-mail: Ali.Mehdirad@va.gov. Cardiology in Review: March/April 2020 - Volume 28 - Issue 2 - p 65-72 doi: 10.1097/CRD.0000000000000280 Buy Metrics Abstract Cardiovascular disorders, such as orthostatic hypotension and supine hypertension, are common in patients with neurodegenerative synucleinopathies such as Parkinson disease (PD), and may also occur in other conditions, such as peripheral neuropathies, that result in autonomic nervous system (ANS) dysfunction. Dysfunction and degeneration of the ANS are implicated in the development of orthostatic and postprandial hypotension and impaired thermoregulation. Neurogenic orthostatic hypotension (nOH) results from sympathetic failure and is a common autonomic disorder in PD. Supine hypertension may also occur as a result of both sympathetic and parasympathetic dysfunction in conjunction with nOH in the majority of patients with PD. Management of supine hypertension in the setting of nOH can be counterintuitive and challenging. Additionally, the presence of other noncardiovascular comorbidities, such as diabetes mellitus and peripheral edema, may further contribute to the burden of disease. ANS dysfunction thus presents major healthcare implications and challenges for neurology and cardiovascular practices, necessitating an integrated neurology and cardiology management approach. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.